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Small Intestinal Bacterial Overgrowth and Systemic Laboratory Parameters: A Multivariable Cross-Sectional Analysis.

Monika Waśkow1, Krzysztof S Malinowski2, Magdalena Tańska1

  • 1Institute of Health Sciences, Pomeranian University of Slupsk, 76-200 Slupsk, Poland.

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|March 14, 2026
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Summary

Small intestinal bacterial overgrowth (SIBO) is not independently linked to vitamin D deficiency or inflammation markers. Host factors like BMI and age significantly influence these lab results more than SIBO.

Keywords:
25-hydroxyvitamin DRDW-SDSIBOcross-sectional studyleukocyte countmultivariable analysissmall intestinal bacterial overgrowthvitamin D

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Area of Science:

  • Gastroenterology
  • Internal Medicine
  • Nutritional Science

Background:

  • Small intestinal bacterial overgrowth (SIBO) is suspected to correlate with systemic inflammation and vitamin D deficiency.
  • The independent clinical significance of SIBO in relation to these markers requires further investigation.

Purpose of the Study:

  • To determine if SIBO is independently associated with vitamin D status and systemic hematological markers.
  • To evaluate the influence of host-related factors such as age, sex, and BMI on these associations.

Main Methods:

  • A cross-sectional study involving 162 adults who underwent hydrogen breath testing.
  • Analysis of serum 25-hydroxyvitamin D [25(OH)D], leukocyte count, red blood cell distribution width-standard deviation (RDW-SD), and C-reactive protein.
  • Multivariable regression models were used to adjust for age, sex, and BMI, examining SIBO status and hydrogen increment as variables.

Main Results:

  • Unadjusted analyses showed lower 25(OH)D and higher leukocyte counts in SIBO-positive individuals.
  • After adjusting for age, sex, and BMI, SIBO status was not independently associated with 25(OH)D, leukocyte count, or RDW-SD.
  • BMI was independently linked to leukocyte count, and age to RDW-SD; hydrogen increment showed no correlation with laboratory parameters.

Conclusions:

  • SIBO does not appear to be an independent predictor of vitamin D status or systemic hematological markers.
  • Host factors, specifically BMI and age, demonstrate a more significant impact on laboratory parameter variability compared to SIBO.
  • Further research may be needed to elucidate the complex interplay between SIBO, host factors, and systemic health markers.